Diabetes in Youth May Increase Risk of Alzheimer’s Disease Later in Life

Blood biomarkers present in young people with diabetes include signs of neurodegeneration in the blood and levels of amyloid and tau proteins in the brain.

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Blood biomarkers present in young people with diabetes may indicate they are at higher risk of developing neurodegenerative diseases like Alzheimer’s disease (AD) later in life, according to a new study published in Endocrines.

“Preliminary evidence shows that preclinical [Alzheimer’s disease] neuropathology is present in young people with youth-onset diabetes,” lead study author Allison Shapiro, assistant professor of pediatrics and endocrinology at the University of Colorado School of Medicine, said in a news release. “These preliminary data suggest the potential for an early-onset [Alzheimer’s disease] risk trajectory in people diagnosed with diabetes in childhood or adolescence.”

According to Ms. Shapiro and her colleagues, young people with diabetes share some of the same biological hallmarks of Alzheimer’s disease. These biomarkers include signs of neurodegeneration in the blood and levels of amyloid and tau proteins in the brain. Beta-amyloid protein can build up and cause plaques in the brain, which trigger many of the classic neurodegenerative signs and symptoms of Alzheimer’s disease.

‘Concerning’ Trajectory

Whereas previous research focused on adult diabetics over 40, who have been found to have a 60 percent to 80 percent increased risk of dementia, this research team examined data from 80 people between the ages of 15 and 28. Participants in the study came from the SEARCH for Diabetes in Youth study and included young people who had Type 1 or Type 2 diabetes or no diabetes. The researchers evaluated biomarkers and PET scans to investigate whether young people with diabetes had signs of neurodegenerative disease.

“Those with youth-onset diabetes showed elevated accumulation of amyloid proteins in areas of the brain where AD (Alzheimer’s disease) occurs,” Ms. Shapiro said.

She also stressed that while young people with diabetes may have biomarkers of Alzheimer’s disease, that does not mean they are exhibiting symptoms of neurodegeneration.

“We are not saying these people have AD or have cognitive impairment,” Ms. Shapiro said. “We are saying that this trajectory is concerning.”

An estimated nearly 7 million Americans live with Alzheimer’s disease, according to the Alzheimer’s Association. The organization reports that that number is expected to rise, likely due to the aging Baby Boomer population.

Obesity Epidemic Fuels Neurodegeneration

Ms. Shapiro and her team noted that rising obesity rates are compounding neurodegenerative disease risk.

“We are about to enter into a different world of health care because of the obesity epidemic in young people,” she said. “Young people are catching up with adults. We are now seeing more aging-related diseases in young people.”

According to the U.S. Centers for Disease Control and Prevention (CDC), nearly one in five (14.7 million) children and adolescents are considered obese. Obesity comes with other health concerns, including high blood pressure, high cholesterol, breathing problems such as asthma, and Type 2 diabetes. The American Diabetes Association reports that about 352,000 Americans under 20 are diabetic.

To help this population, Ms. Shapiro suggests that health care professionals routinely perform cognitive testing typically reserved for older adults.

“The field of diabetes care is beginning to recognize the importance of cognitive testing as a part of clinical follow-up,” Ms. Shapiro said. “And it should be something we consider in youth-onset diabetes as well.”

Ms. Shapiro and her team hope to receive funding to follow up with the same cohort as they age. She noted that follow-up of participants is vital to understanding the risk and driving factors of Alzheimer’s disease and to providing health care professionals and patients with insight that will inform care for youth-onset diabetes patients.